Сучасні медичні технології (Sep 2019)
Predictors of the adverse course at hospital stage of Q-myocardial infarction treatment
Abstract
Purpose of the study. Identify predictors of the course adverse at hospital stage of Q-myocardial infarction treatment. Materials and methods. The study involved 139 patients in the acute stage of Q-MI, average age 66 ± 0,97 year, male – 59%. Patients underwent a general clinical examination, determined the level of glycemia on admission, copeptin, NTproBNP, left ventricular ejection fraction (LVEF). 101 patients have reached cumulative endpoint (CEP), average age of 68 ± 1,02 years, of which male were 57%. As the CEP were considered one of the occurrence adverse events: death on the hospital stage (n = 17, average age 70,4 ± 2,37 years, male – 53%), development of acute heart failure (n = 94, Killip II – n = 52, Killip III n = 42, 52% were male, average age 69,2 ± 8,3 years), decreased LVEF < 45% (n = 64, average age 66 ± 1,22 years, male 63%).38 patients did not have a single endpoint, the average age 62 ± 2,2 years, male 67%. Results. According to multivariate logistic regression analysis, independent risk factors for increased risk of intra-hospital mortality were copeptin level more than 0,87 ng/ml, which increased the odds ratio (OR) by 1,4651 times (p = 0,014) and hyperglycemia on admission more than 9,0 mmol/L, which increased intrahospital mortality by 1,2 times (p = 0,006). Independent risk factors for achieving the CEP were tachycardia (OR = 3,19; p = 0,009), increased copeptin level more than 3,3 pmol/L (OR = 1,52; p = 0,01) and hyperglycemia more than 9,3 mmol/l (OR = 1,20; p = 0,02). Conclusion. Independent risk factors of increasing intra-hospital mortality were the level of copeptin more than 0,87ng/ml and hyperglycemia on admission more than, 9 mmol/l. Dependent and independent risk factors for CEP were tachycardia, an increase in the level of copeptin over 3,3 ng/ml and hyperglycaemia on admission more than 9,3 mmol/l.
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